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Gastric acid secretion and sleep stages during natural night sleep.

Gastric acid secretion during natural sleep was studied in 4 healthy female volunteers for 11 nights. Acid output was measured by means of intragastric titration and a telemetering capsule, and sleep was monitored continuously by recording EEG and eye movements. Compared to the waking state, sleep was found to be associated with significantly lower levels of acid secretion. Although there were no significant differences between acid secretion during sleep stages 1 to 4 and rapid eye movement (REM), acid secretion decreased with deeper stages of sleep. During all REM phases only small amounts of acid were produced. Arousal or periods of waking in the course of the night, as well as waking in the morning, were associated with an increase in acid output.

Adult

Relationship of arousal threshold to sleep stage distribution and subjective estimates of depth and quality of sleep.

The relationship of arousal threshold, amounts of various sleep stages, and subjective rating of sleep was studied in two separate experiments involving 7 and 26 young adult subjects, respectively. Electroencephalographic sleep stage data, subjective response data, and arousal threshold data were collected over a series of nights in the sleep laboratory. Only nonsignificant relationships were found between magnitude of arousal threshold and amounts of various sleep stages or subjective rating of sleep quality in between-subjects analyses. However, when the nights representing extremes in arousal threshold were examined within-subject, it was found that nights of high threshold were accompanied by subjective reports of significantly better sleep in both studies and by a significant decrease in the amount of stage W in one study. Arousal threshold was not related to subjective depth of sleep in either study. Rather, subjective ratings of depth of sleep were significantly related to the amount of EEG-defined wakefulness and stage 1.

Adolescent

Flurazepam effects on slow-wave sleep: stage 4 suppressed but number of delta waves constant.

Repeated administration of flurazepam reduced stage 4 sleep (high delta-wave concentration) but produced a greater increase in stage 2 duration so that total sleep time was increased. Computer analysis revealed that the increased amount of stage 2 (low delta-wave concentration) sleep provided a number and duration of delta waves sufficient to offset the loss of delta activity in stage 4. However, the amplitude of the average delta wave was reduced. These results demonstrate the value of direct quantification of delta-wave activity, the variable that underlies visual classification of slow-wave sleep into stages 2 to 4. They also give rise to new hypotheses regarding the relative absence of side effects in spite of profound stage 4 suppression by flurazepam and the mechanisms by which total sleep time is increased by this drug.

Anti-Anxiety Agents

Induction of neurasthenic musculoskeletal pain syndrome by selective sleep stage deprivation.

Two groups of young, healthy, nonathletic volunteers were subjected to selective sleep stage deprivation. Six subjects were deprived of stage 4 sleep and seven subjects of REM sleep. The stage 4 deprived group reported more musculoskeletal symptoms during the deprivation condition than did the REM deprived group. The stage 4 deprived group also showed a significant increase in muscle tenderness between the baseline and deprivation conditions and an altered pattern of overnight change in muscle tenderness in response to deprivation. The REM deprived group did not show either of these changes. These results are discussed in the light of the previously postulated relationship between NREM sleep disturbance and muscoloskeletal pain in patients with so-called "Fibrositis syndrome."

Adult

A simple sleep stage detector for the rat.

A simple sleep stage detector for the rat is described, which uses as its sources of input the signal from a single hippocampal recording electrode and the signal generated by a motion indicator. The device is suitable for use in sleep studies and in experiments on REM sleep deprivation.

Animals

The nocturnal intragastric pH in EEG sleep stages in peptic ulcer patients.

In 10 peptic ulcer patients, 5 duodenal ulcer and 5 gastric ulcer patients, the relation of nocturnal intragastric pH to EEG sleep stages was examined. The nocturnal intragastric pH was monitored by pH-measuring telemeter and sleep stages were recorded simultaneously by electroencephalography throughout the night. The EEG sleep stages were classified after the criteria of Dement and Kleitman. The average of intragastric pH level at each sleep stage was higher in gastric ulcer than the duodenal ulcer. The intragastric pH level became low as the patients' sleep advanced to deep stage. This tendency was more likely in duodenal ulcer patients than the gastric ulcer patients, which indicated that the cephalic phase might play an important role in the pathogenesis of hyperacidity in duodenal ulcer.

Adult

Effect of methylphenidate on sleep stages and ultradian rhythms in hyperactive children.

The effect of methylphenidate on sleep pattern was assessed in four hyperactive children. Two nights of sleep were recorded before drug administration, sleep was again recorded on the 1st and 21st nights during drug administration, and also on the 1st and 2nd nights of drug withdrawal. All patients showed behavioral improvement during drug administration; however, no drug effect was seen when standard sleep variables such as sleep stages and sleep time were examined. This analysis was supplemented by an examination of the REM cycle and computer extraction of the delta cycle; both are ultradian (40 to 140 minutes) rhythms. These rhythms were found to be intact in hyperactive patients. Although the REM cycle was not affected by drug administration or withdrawal, a trend toward lengthening of the delta cycle was found on drug withdrawal.

Child

Plasma parathyroid hormone and calcium are related to sleep stage cycles.

To study dynamic interactions among parathyroid hormone (PTH), plasma calcium, and brain states, seven normal subjects were studied for a total of eight nights in our sleep laboratories. Plasma samples were obtained at 10- to 20-min intervals for PTH and calcium determinations. Electroencephalogram, eye movements, and muscle tone were recorded to determine sleep stages. On each night, several distinct peaks in PTH concentration were seen, which in some cases exceeded the all night mean PTH by as much as 300%. Peaks in plasma PTH were significantly nonrandom and tended to recur about every 100 min. PTH concentration was significantly related to cycles of stages 3 and 4 sleep. Total plasma calcium varied less but was significantly related to cycles of rapid eye movement sleep and to cycles of stage 2 sleep. PTH and calcium were significantly interrelated, especially at high frequencies above 40 cycles/day (1 cycle 36 min). In the 14.4 cycles/day (1 cycle/100 min) frequency range where most PTH and calcium variability was found, however, PTH and calcium were more closely related to sleep stages than to each other. These results suggest that the regulation of PTH and calcium is complex and may involve interactions with neural systems.

Adult

Sleep-stage regulation of ventricular arrhythmias in the unanesthetized pig.

In two groups of purebred juvenile Hampshire pigs, left anterior descending coronary occluders were implanted. The pigs were then adapted to the recording chamber until they would manifest a criterion pattern of sleep while in it. In group A, permanent coronary artery occlusions were produced, and the effects of various sleep stages on the resultant cardiac arrhythmias were observed. Sleep intervals during which transitional and slow wave (SW) sleep alternated were correlated with increased arrhythmias relative to the awake state (P less than 0.04). The increase was maximum during sustained periods of SW sleep. Intervals during which rapid eye movement (REM) sleep predominated were correlated with a reduction in arrhythmias. In group B, temporary occlusions were made during both an awake condition and after criterion patterns of either SW or REM sleep. Occlusions after SW sleep reduced the ventricular fibrillation latency compared with that during the awake control state (P less than 0.05), whereas occlusions after REM sleep increased ventricular fibrillation latency (P less than 0.05). We conclude that SW SLEEP, BUT NOT REM sleep, has a deleterious effect on the ischemic myocardium. REM sleep may have a beneficial effect, since it increases ventricular fibrillation latency. Heart rate changes do not appear to be correlated with the effects of either sleep stage.

Animals

[General trends of sleep stages studied by applying orthogonal polynomials].

In an attempt to describe in a dynamic way the evolution of sleep stages or of total sleep as a function of time, we applied to the totality of stages a method of fitting by orthogonal polynomials. With some precautions, the proposed method is of very general application, in man as in animals. It permits description of the evolution of a sleep stage throughout the night by a simple analytical function; further it allows comparisons and statistical treatment separately for each characteristic of this evolution (level, slope and curvature). Finally, the calculations can be done on a general average of a series of measurements or on individual data.

Adult

Seasonal patterns of sleep stages and secretion of cortisol and growth hormone during 24 hour periods in northern Norway.

A group of 7 healthy male subjects was studied in regard to sleep stages and 24 h plasma cortisol and growth hormone patterns during the 4 seasons of the year in an Arctic environment (Tromsø, Norway). No difference in total sleep or sleep stage per cents was found for any of the yearly seasons. A small but statistical significant increase in mean plasma cortisol concentration and amount secreted for 24 h was found for the autumn-winter seasons, as compared with the spring and summer. However, no difference in the circadian curve of cortisol hormonal pattern was found. All subjects secreted growth hormone shortly after sleep onset at night and no difference was found as a function of season of the year.

Adult

[Temporal organization of sleep stages in man].

By fitting orthogonal polynomials to the cumulated occurrences of sleep stages, it is possible to describe in a simple form their general trend, i.e. their temporal evolution, in the absence of cyclic ultradian variations. Thus, stages 1, 2 and 3 can be described by a cubic function, REM stage by a parabolic one, while total sleep itself is linear. The fittings can be performed on a general average or on individual data, allowing completion of the subject's clinical description. The first derivative of the general trends gives the instantaneous trend, which has the form of a probability, that of the occurrence of a given stage at a given moment of the night. The study of normal sleep with this technique reveals new aspects of its evolution as a function of time, and makes it possible to propose and test hypotheses on the reciprocal relations between stages.

Adult

On the stationarity and normality of the electroencephalographic data during sleep stages.

In this paper, we show techniques to examine the stationarity and the normality of time series as well as results obtained by applying these techniques to EEG data during sleep stages. Many statistical analyses of the EEG data are based on the assumption that the EEG data are stationary and normally distributed. However, the problem is to know the length of data which is most appropriate for the statistical analysis. From the analysis, it is found that a decreased length of data implies an increased degree of stationarity and normality in each stage of sleep. However, for the practical stationary analysis of EEG data, it is shown that it is appropriate to take about 5 s during sleep state. Stationarity is fulfilled to a relatively large extent in REM but more seldom in stage 2. In the case of short data, asymmetric distribution occupies the large parts of non-normal distribution. As the length of data increases the proportion which is symmetric but sharper or flatter than the normal distribution increases.

Computers

Dissociation of sleep stages between the two hemispheres in a case with unilateral thalamic tumor.

A case with an astrocytoma in the right basal ganglia, suspected of having originated from the posterior ventro-lateral part of the thalamus, without any clinical findings indicating severe internal hydrocephalus and cortical damaged, showed dissociation of sleep stages between the two hemispheres, i.e., the affected side always fell earlier into deeper stages of sleep and was more difficult to arouse by sonic stimulations than the other side. It is assumed that this bilateral dissociation with ipsilateral deactivation is due to the severe unilateral reduction of EEG activating influences from the brain stem and a possible functional damage to the interthalamic commissures. This finding can be explained sufficiently by recent theories based on experimental results in animals. The clinical value of this findings is also discussed in this paper.

Adolescent

Self-mutilation and sleep stage in the Lesch-Nyhan syndrome.

Correlation of self-mutilation and sleep stage in the Lesch-Nyhan syndrome was studied by a polygraphic method. Five patients and three control boys were monitored with EEG, EOG, EMG, ECG and respiration throughout the night. The results were as follows: 1. The sleep-time of the patients was much disturbed during the night. 2. Decreased REM density was noticed with low DQ of the patients. 3. Self-mutilation during sleep-time was observed a lot in stages 1, 2, and REM in two cases. 4. No correlation was observed between body movement and self-mutilation in the Lesch-Nyhan syndrome. These data suggested functional disorders of the frontal lobe in the patients.

Adolescent

[Local temperature characteristics of the isolated cortex in wakefulness and alteration of the sleep stages].

In cats, changes of the brain electric activity were followed by local temperature shifts in isolated and in intact cortex: the transition from slow wave sleep to paradoxical sleep and from quiet to active wakefulness were accompanied by increasing of the cortex temperature, while transition from paradoxical sleep to slow sleep decreased the temperature. During falling asleep and alternation of the sleep stages, both in isolated and intact cortex, the temperature shifts preceded the electric activity changes. The temperature of isolated cortex is by 0.2 degrees lower than that of the opposite intact hemisphere.

Animals